Comparative study of three alcohol-related harm reduction programs: an ideal-type analysis

Abstract

The present article aims to identify appropriate interventional levers based on different types of publics and professionals, by comparing three alcohol-related harm-reduction programs implemented in France. To offer a transversal and more relevant analysis for action, we carried out an analysis by ideal types based on typical profiles of users and professionals. Twenty-one professionals using one of the three interventions took part in this study, and twenty-one users were included. Three typical profiles for users have therefore been identified: the socially included drug user, using alcohol only not targeting abstinence, the multiple substance user in very precarious situation with an ambivalent attitude to their substance use, and the middle-class drug user who want to achieve abstinence and feels guilty. Four typical profiles for professionals have also been identified: the isolated leader, the leader of a group, the willing professional eager to improve their practices, and the professional overwhelmed by a failing system. Depending on the user's profile, certain levers and professional profiles appear to be particularly suitable for ensuring the effectiveness of the intervention and the user's adherence to the program. All our findings point to the need to adapt interventions to users' needs, rather than expecting users to adapt to the objectives of the interventions. Mobilization of the notion of proportionate universalism, as defined in 2010, could be a relevant perspective for AHR interventions.